Background and Objective: These studies are targeted towards understanding the pathogenesis of psoriatic arthritis and the development of specific immunotherapies for psoriatic arthritis, a relatively common chronic inflammatory disease affecting the skin and joints. Patients with known or suspected psoriatic arthritis are evaluated at the Clinical Center. Studies include characterization of the clinical and laboratory features of the disease, research studies of the natural history, pathogenesis and determination of the patients' eligibility to enter experimental therapeutic protocols. Results: Recruitment in this study was slow over the last year primarily because the beneficial effect and wide availability and ongoing clinical trials of new TNF-inhibitors in the community. Conclusion and Significance: This study allows us to recruit patients for future treatment protocols, provide second opinions for patients with complicated disease and to further explore the pathogenesis of psoriatic arthritis. Lay Summary. Psoriasis is a common inflammatory disease of the skin that affects approximately 2% of the population of the USA. Psoriasis is accompanied by a destructive arthritis in 5-15% of patients. Our studies examine the relative contribution of certain types of blood cells and their products in causing this disease. Thus far we have established an important role of certain blood cells called T lymphocytes and monocytes in causing inflammation. In addition, we have identified several molecules produced by these cells that cause inflammation which could be targets for future therapy. Progress since last year 1. A manuscript discussing the results of a therapeutic protocol using fludarabine in patients with psoriatic arthritis was published.